مجله علوم پزشکی رازی
سال بیست و سوم شماره 1 (پیاپی 142، فروردین 1395)

Free radicals cause different diseases. Today’s finding of natural antioxidants is an interest. Marine sponges will be an important drug source in future. In this study the antioxidative effects of some marine sponges from Chabahar Tidal Seashores investigated.
After gathering and recognition of sponges, distilled water and methanol 96% used as solvent for extraction. Free radical scavenging activity, metal chelating activity and reduction power were measured after total phenolic content assayed in the extracts and compared with the standards.
water extracts of Dysideidae, Halichondriidae and callyspongia showed more free radical scavenging activity in compare with alcoholic extract (p Results showed sponges extracts in this study had a good content of antioxidative activity especially in metal chelating activity and with more clinical study we could reach to a way for drug delivery from the marine environment.

Malaria is an acute and chronic disease caused by obligate intracellular protozoan parasites of the genus plasmodium, transmitted through the bite of female anopheles mosquitoes. According to the World Health Organization (WHO) report, currently malaria transmits in 104 countries and due to a failure in the fight against this disease, their control and elimination is difficult. The parasite resistance to current and inexpensive drugs is one of the difficulties in the way of the elimination of malaria. Furthermore, achievement to a new drug with different mechanism of action is inevitable.In this respect, research groups focused on heterocyclic rings to find new drugs with different mechanism of action compared to current drugs. So, they synthesized various derivatives and evaluated their antimalarial activity on different stages of the parasite’s life cycle. The compounds containing quinolone ring with diverse substituents on ring presented suitable activity on blood, liver and gametocyte stages. Furthermore, according to the tendency of these compounds on the different stages of the malaria parasite, they canbe considered as lead compound to achieve new antimalarial drugs with different mechanisms of action and evaluated further.Due to theimportance of the subject, in this review article are introduced some quinolone derivatives with antimalarial activity.

Most studies have shown that there are association between the development and malignancy of brain tumors and tumor suppressor genes and oncogenes. The aim of this project was to investigate the P53 gene mutations in exon 8 in patients with astrocytoma type’s brain tumor.
In this present survey, The DNA isolation from 30 samples of brain tissue was done by phenol-chloroform protocols. After PCR amplification for p53 at exon 8, screening by SSCP (Single -Strand Conformation Polymorphism) was performed to determine the mobility shifts. Samples that have shift were sequenced.
A malignant missense nucleotide changes (g.13851A>G) was found at exon 8 in a sample with grade 4 of astrocytoma. The sequence changes at protein level of this mutations is K291E.
Based of the study finding, the above nucleotide change which was found within the protein's DNA binding domain could be a pathogenic mutation. This mutation can prevent tumor suppressing function of p53 and possibly causes cancer. This may be important in early diagnosis and gene therapy of brain tumors.

Many systems are being applied to predict mortality of the patients in ICUs. In this study, the patients admitted to EICU were compared to those of MICU and SICU using APACHE-II scoring system to predict their mortality.
In this retrospective cohort study, the files of 290 patients admitted toEICU, MICU, and SICU of RasoulAkram Hospital in Tehran, were evaluated in a 6 month period. The outcome of every patient wascollected, patients’ APACHE-II scores were calculated, and the departments were compared each other.
There was no statistically meaningful difference among the patients of departments evaluated for age and sex. APACHE-II scoresof patients of EICU were meaningfully lower than two other wards.The stay length and mortality rate of patients admitted to EICU were meaningfully lower than two other wards.
The results of this research showed that in the hospital studied, the disease severity of the patients admitted to MICU and SICU were higher than the patients of EICU. On the other hand, the patients admitted to EICU, had lower length of stay and mortality compared to the two other wards.

Trichoepithelioma (TE) is a benign skin tumor with follicular differentiation, which sometimes is difficult to distinguish clinically and histologically from cutaneous basal cell carcinoma (BCC). An accurate diagnosis of these lesions is essential for effective and appropriate therapeutic decisions. Therefore, several attempts have been made to identify immunohistochemical differences between these entities. The aim of this study was to evaluate the pattern of expression of Her2 protein in cutaneous BCC from TE using immunohistochemistry.
In this cross sectional study first pilot study was done with 5 cases of BCC and 5 cases of TE. According to the results of pilot study 60 cases including 30 cases of BCC and 30 cases of TE were obtained from archival files of the Pathology Department of Rasoul-e-Akram hospital, Razi Hospital and Danesh pathology laboratory of Tehran. Selected tissue blocks were recut and analyzed. Immunohistochemistry method was used for evaluation of expression pattern of Her2 protein in TE compared to BCC SPSS software and Fisher’s exact test was used for statistical analysis of data.
In current study, percent and intensity of membranous staining of Her2 protein in TE were statically significant from BCC (p Results of this study showed that the pattern of expression of Her2 proteins is different in BCC and TE. Thus pattern of expression of this protein can be helpful in differentiation of BCC and TE.

Identifying the risk factors of recurrence of a disease is important both for physicians and patients. Analyzing the first recurrence may lead to an inaccurate evaluation of risk factors as it may not reflect the history of disease completely and may result in the loss of some valuable information. This study was aimed to analyze the time up to the recurrent relapses of bipolar disorder as well as determining the risk factors that may lead to the recurrence of the disease.
In this retrospective longitudinal study, the data was extracted from records of 226 bipolar disorder patients with at least one relapse in Razi Psychiatric Educational-Medical Center in Tehran. Semi-parametric without frailty and semi-parametric shared gamma frailty models were fitted to data and analyzed using R software to estimate accelerated factors to identify some risk factors of relapses of bipolar disorder.
Of 226 patients, 65.3%were male and the rest female. Average age at onset of disease for female was 25± and 27± for males.43.3% had a suicide attempt, 65.1% history of hospitalization, and 58.5% family history. In semi parametric without frailty model age at onset of disease (p=0.009) detection stability (p with respect to recurrent property of bipolar disorder and existing correlation among relapse times, continuous efforts and special preventive treatments to decrease relapse probability especially in patients who experience relapses in low ages, those with history of hospitalization and patient who had not detection stability are recommended.

A sural artery flap is a fasciocutaneous one based on the reverse blood flow and the anastomosis between the superficial sural artery and the perforators of peroneal artery. This flap is used in order to reconstruct the soft tissue defects of the distal leg, ankle and heel and also to cover the vessels, tendons and bones. It is possible to cover the defects in size 10*12 cm with this flap, classically; as well, the design of the flap is being done by the limited shapes such as L and T-shaped. The purpose of this article is to introduce the new design of this flap to creating the most level of consistency with the shape of the defect.
The patient was a twelve year old girl who faced a large defect and the separation of the soft tissue of the heel and ankle of the right foot by an accident with a motorcycle about three weeks prior to her referral as her medial malleolus and Achilles tendon were exposed. Then, after the first reconstruction in the orthopedically services, she faced severe necrosis of tissue and exposition of the heel's bone and Achilles tendon. There was not a clear sensory disorder in her fingers and the movement of her ankle and toes were intact. During the first surgical operation, debridement of the necrotic tissue was occurred and preparation of the fields for the pediculate flap was done. Then bandage, dressing and splint–making were completed. The second operational surgery was done for designing a flap and during this operation, the sural flap was designed in a boot – shaped way due to the impossibility of covering the defect using the classic method and the obvious need for longer pedicle. In the end, the basis of flap was cut during the third operational surgery and the final reconstruction of the damage was done. Moreover, the soft tissue defect of the donor flap was reconstructed by the cutaneous graft from the medial surface of the thigh of the same foot. Then, the patient was followed for three months.
Findings: The final result of designing the sural flap in a boot – shaped way for this area of lower limbs was remarkable because there were no side effects such as venous congestion, superficial necrosis and the bleeding from the flap's edge and finally, the patient could properly walk. The effects of removing the flap in the donor site and the sensory disorder resulted from removing the flap were trivial and negligible and also, the patient returned to her daily life in almost no time.
A boot-shaped sural flap is one of the best choices for covering the defects of soft tissue of the heel and ankle. In the classic term, it is formed in a rectangular or oval shape but this flap was a versatile flap and can be designed in other shapes for increasing the efficiency of the flap and decreasing the side effects in terms of the shape and size of the defects.

The present study aimed at determining the role of Intolerance of Uncertainty and positive Metacognitive Beliefs in Obsessive Compulsive and Depression disorders.
Seventy patients with obsessive compulsive disorders and depression referred to psychiatry clinics of Baghiyatallah and Taleghani hospitals of Tehran were chosen via convenient sampling and were compared with 35 normal individuals (age range of 20 to 38) on intolerance of uncertainty scale and positive metacognitive beliefs subscale. Then data were analyzed using one way variance analysis and Scheffe post-hoc test. Research design of present study was Ex post facto research.
Patients suffering from obsessive compulsive disorder and depression gained higher scores than normal group in intolerance of uncertainty scale. Regarding positive metacognitive beliefs, patients with obsessive compulsive disorder gained higher scores than depressive patients; and depressive patients gained higher scores than normal group.
Considering the crucial role of intolerance of uncertainty and positive metacognitive beliefs in obsessive compulsive disorder and depression, they should receive special attention in treatment.